1. Field of the Invention
The present invention relates generally to medical apparatus and methods. More particularly, the present invention relates to methods, devices, and kits for tying knots in suture used in surgical procedures.
At present, most suture knots used in surgical procedures are tied completely by hand, particularly in open surgical procedures where a surgeon has free access to the tissue site to be surgically closed. A variety of knot tying apparatus have been proposed for use in instances where the surgeon does not have direct access, such as laparoscopic and other minimally invasive procedures. Most prior knot tying devices, however, are useful only for tying relatively simple knots and are often combined with a needle driver or other suturing device, rendering the design of the primary suturing instrument more complicated.
For these reasons, it would be desirable to provide improved knot tying devices, kits, and methods which are useful for tying free suture ends which have been deployed by virtually any known suturing technique. The devices will preferably be capable of imparting both simple and complex knot structures in the suture ends in a repeatable and reliable manner. The devices and methods should be easy to use, even in a surgical environment where the suture to be tied may be covered with blood, tissue debris, and other substances which would render tying difficult. In addition, the devices and kits should be of simple construction, be economical to produce, and be capable of being packaged in small, sterile kits for convenient maintenance in a hospital inventory and subsequent use in the operating room environment. At least some of these objectives will be met by the invention described hereinafter.
2. Description of the Background Art
U.S. Pat. No. 5,217,470, describes a device for forming a "protoknot" in suture by direct passage of one end of the suture through a pre-formed partial knot in another end of the suture. Other suture knotting and tying apparatus are described in U.S. Pat. Nos. 5,814,069; 5,776,150; 5,769,862; 5,728,109; 5,454,821; 5,454,820; 5,163,946; and 5,087,956.